NPI | 1619659422 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95029609) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95231090) |
Enumeration Date | 2023-08-01 |
Last Update Date | 2024-03-29 |